HealthDay News — Use of psychotropic medications in addition to prescription opioids during pregnancy is associated with increased risk and severity of neonatal drug withdrawal, according to a study published in The BMJ.

Krista F. Huybrechts, PhD, from Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues conducted an observational cohort study involving 201,275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.

The researchers observed variation in the absolute risk for neonatal drug withdrawal from 1.0% to 11.4% for infants exposed in utero to prescription opioids alone and opioids co-prescribed with gabapentin, respectively. 

Among neonates exposed in utero to prescription opioids, the propensity score-adjusted relative risk was 1.34 (95% CI, 1.22-1.47) with concomitant exposure to antidepressants, 1.49 (95% CI, 1.35-1.63) with benzodiazepines, 1.61 (95% CI, 1.26-2.06) with gabapentin, 1.20 (95% CI, 0.95-1.51) with antipsychotics, and 1.01 (95% CI, 0.88-1.15) with non-benzodiazepine hypnotics (Z-drugs). The risk of withdrawal was increased two-fold with in utero exposure to 2 or more psychotropic medications along with opioids (2.05; 95% CI, 1.77-2.37).

“The current findings suggest that these drugs could further increase the risk and severity of neonatal drug withdrawal,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

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Huybrechts KF, Bateman BT, Desai RJ, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ. 2017;358:j3326.